The government is looking for ways to stop the epidemic

Yesterday, the head of the Ministry of Health, Veronika Skvortsova, presented to Prime Minister Dmitry Medvedev the concept of a national strategy to combat HIV, which should be developed by November 2016. Mrs. Skvortsova proposed focusing on the treatment of already infected citizens, for which it is necessary to allocate at least 20 billion rubles from the budget. for the purchase of medicines. The prime minister approved the spending, but with a “commander’s decision” he halved the time for preparing the concept. In turn, doctors point out that the allocated funds are still not enough to treat all patients, and call for improving the HIV prevention system.

Photo: Alexander Miridonov, Kommersant / buy photo

The head of the Federal AIDS Center, Vadim Pokrovsky, drew the attention of the country's authorities to the problem of HIV back in May. The academician declared a real national catastrophe - according to him, in most countries of the world the HIV epidemic has declined, but in Russia the situation is still the opposite. He warned that by the end of 2015, the country could have 1 million people infected (including those who died from AIDS), and in two to three years this figure will double. A few days later, the government instructed the Ministry of Health to develop a national strategy to combat HIV.

“It’s like washing your hands before eating.”

Yesterday, Prime Minister Dmitry Medvedev held a separate meeting of the government commission on protecting citizens' health dedicated to this problem. “HIV is a very sensitive topic that we don’t really like to talk about, let’s be honest,” the prime minister admitted. “But the situation has changed, and now this most dangerous infection can affect almost any person. And pretend that it’s somewhere far from us and only affecting marginalized groups of the population, it’s just not fair.” Mr. Medvedev recalled that the system of early detection and prevention of HIV began to be developed for the first time ten years ago, when the national project “Health” was launched. “An obvious success is the fact that now in Russia healthy children are born from HIV-infected mothers in 98% of cases,” said the Prime Minister.

This is where the list of successes ended - Mr. Medvedev began to talk in detail about the problems. First of all, the system for distributing medicines to patients has not been established. In the regions, there are constantly interruptions in the supply of drugs and test systems (Kommersant has repeatedly reported about this, most recently in the issue dated March 14). The prevention system is also not working very well, the prime minister made it clear: “We need to raise the level of people’s knowledge and focus on large-scale information work, especially among high school students and young people.” In addition, it was not possible to destroy public stereotypes regarding HIV. “Despite all our efforts, the problem remains very acute,” admitted Dmitry Medvedev.

The head of the Ministry of Health, Veronika Skvortsova, said that since 1987, 742,631 HIV-infected people have been identified in Russia. “Since 2006, there has been a steady increase in HIV infection,” she said. “The increase ranges from 6% to 16% per year.” In 2014, 335.3 cases of HIV per 100 thousand people were registered in the Russian Federation, which is one and a half times higher than in the European Union countries (216 cases). The highest level of HIV prevalence was in 22 constituent entities of the Russian Federation - Sverdlovsk, Kemerovo, Irkutsk, Samara and other regions. In these regions, Ms. Skvortsova promised to form a “total vigilance system”: they will offer an HIV test to everyone who seeks any medical help. This will cost the budget approximately 112 million rubles. Another 180 million rubles. The Ministry of Health is going to spend on large-scale information campaigns in the regions.

At the speed of AIDS

But the main thing that will be emphasized in the upcoming strategy is increasing the number of patients receiving HIV therapy at the expense of the budget. The drugs used do not destroy the virus, but reduce its activity, and as a result, the patient has less chance of infecting others. According to Ms. Skvortsova, “the current level of funding allows us to provide medicines to about 23% of registered HIV-infected people in 2015.” With an additional reduction in the price of medicines, this figure will increase to 30%, but even this will not improve the situation. “In this case, a scenario of a generalized epidemic will develop, in which by 2020 the number of patients will increase by 250%,” said the head of the Ministry of Health. This forecast impressed the Prime Minister so much that he asked Veronika Skvortsova to repeat it. “The epidemic will get out of control, and the risk of infection will increase significantly for every Russian,” the head of the Ministry of Health confirmed. According to her, the World Health Organization recommends providing therapy to 90% of cases. “If we cover 60% of treatment, we will be able to ensure a regression of morbidity by 2023. With coverage of 70% - by 2020, and with 80% - in the next two to three years,” Mrs. Skvortsova promised. According to her, all the proposals made will be included in the strategy, which will be developed by November 2016.

“Why do you need so much time?” Dmitry Medvedev asked irritably. “Do we really need to spend another year to adopt this strategy? Let’s just set a deadline of six months from today by commander’s decision.” Later, Veronika Skvortsova told reporters that the government would additionally allocate at least 20 billion rubles to fight HIV, a significant part of which would be used to purchase drugs. However, these expenses may increase in the future, experts say, and it will be difficult to achieve the desired results. The Ministry of Health’s statistics do not take into account the large number of citizens who do not know that they are already infected, Vadim Pokrovsky emphasized in an interview with Kommersant. “That is, you first need to massively survey the population in order to identify as many patients as possible. And then provide therapy to at least 70% of them,” said the academician. “To do this, it will be necessary to increase the number of doctors by five times, provide infrastructure for them and laboratory control.” . According to him, when developing a national strategy, it is necessary to use the experience of those countries where the epidemic was stopped, for example Germany. “This means we need to introduce compulsory sexuality education from a very early age,” said the doctor. “We need to work with drug users—introduce a syringe exchange system, other harm reduction programs, as well as substitution therapy. Such a strategy needs to be seriously developed, and not just given out money.” and demand results."

Alexander Chernykh

Dmitry Medvedev accelerated the fight against HIV